| NPI | 1437587938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA PY60631498) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH6046007) |
| Enumeration Date | 2013-10-18 |
| Last Update Date | 2016-06-03 |