| NPI | 1245524347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60311996) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60223010) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2012-12-10 |