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 |