NPI | 1134566672 |
---|---|
Professional Name | THEA DIANE SHIRA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG60315060) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60882908) |
Enumeration Date | 2013-05-23 |
Last Update Date | 2018-07-30 |