| NPI | 1679867055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60271806) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60215201) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2015-03-23 |