| NPI | 1164915823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3596) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC61005451) |
| 103T00000X Psychologist (Licence: WA PY61180654) | |
| 103TH0004X Psychologist, Health | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2023-08-18 |