| NPI | 1154905073 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA 61233152)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61080246)  | 
| Enumeration Date | 2021-05-06 | 
| Last Update Date | 2024-09-17 |