| NPI | 1518441559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WA PY60938522) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2018-09-15 |
| Last Update Date | 2020-01-08 |