| NPI | 1255780219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60708359) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60576837) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-03-07 |