NPI | 1922401926 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY 60533331) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MHCA.MC.60503787) |
Enumeration Date | 2014-10-03 |
Last Update Date | 2015-08-11 |