| NPI | 1205317211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY61370639) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA MC6081228) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2024-06-14 |