| NPI | 1205262722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60610064) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 5186-125) |
| 225C00000X Rehabilitation Counselor (Licence: WI 00090487) | |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2025-03-25 |