| NPI | 1609986132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2462) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH00011038) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2009-10-23 |