| NPI | 1568884641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH60250630) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: WA LH60250630) |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-01-09 |