| NPI | 1003192535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2011037832) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2011032755) |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2012-10-08 |