| NPI | 1447656376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60747612) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA LH60459199) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2020-11-06 |