| NPI | 1174998678 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60754240) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60553211) | 
| Enumeration Date | 2015-12-09 | 
| Last Update Date | 2020-01-14 |