NPI | 1386048361 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY60704294) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60512436) |
Enumeration Date | 2014-10-20 |
Last Update Date | 2018-03-17 |