| NPI | 1679698294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA 2401) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: OR 1554) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |