| NPI | 1871654954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY60547876) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH00009278) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2022-05-03 |