| NPI | 1851509418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00002105) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 002655-031606) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |