| NPI | 1386952190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY 60088363) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 1593) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2013-07-08 |