| NPI | 1174863781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60365672) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA 60308302) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2013-10-03 |