| NPI | 1275642936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: WA MA00023037) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC00049330) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-10-11 |