| NPI | 1619307915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG 60710317) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC007543) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2017-04-27 |