| NPI | 1619302072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WA PY60480722) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA MC60269765) |
| Enumeration Date | 2013-09-04 |
| Last Update Date | 2021-05-17 |