| NPI | 1568710481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA 60313605) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60291493) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2013-07-22 |