| NPI | 1164950390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60807236) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60692922) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2018-03-05 |