| NPI | 1598244576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: WA 601-505-27) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 60150527) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |