| NPI | 1669114393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA PY60280124) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA PY60280124) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |