| NPI | 1750436143 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LW00004680) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW00004680) | 
| 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: WA RN00045814) | |
| Enumeration Date | 2007-01-24 | 
| Last Update Date | 2009-11-30 |