| NPI | 1558814012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61069944) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC60950807) |
| 101YM0800X Counselor, Mental Health (Licence: WA MC60950807) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2021-01-15 |