| NPI | 1124584511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61357823) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 03025) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2022-11-08 |