| NPI | 1407909054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA AP30006745) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WA RN00141657) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |