| NPI | 1649913823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC61429743) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 21254020901) |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2023-05-26 |