| NPI | 1578036315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60944370) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH60879543) |
| 103TC0700X Psychologist Clinical (Licence: WA PY60944370) | |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2021-05-04 |