| NPI | 1598348203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY61496349) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA MC61159152) |
| 101Y00000X Counselor (Licence: WA MC61159152) | |
| 103T00000X Psychologist | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2024-08-01 |