| NPI | 1346648771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3101) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical (Licence: WA PY60900766) | |
| 103TF0200X Psychologist, Forensic (Licence: OR 3101) | |
| 103TF0200X Psychologist, Forensic (Licence: WA PY60900766) | |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2021-06-09 |