| NPI | 1780066381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60654578) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC 60462365) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2017-06-02 |