| NPI | 1962995407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 175352) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA 175352) |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2021-12-14 |