| NPI | 1003265752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 40645) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 3462) |
| 106H00000X Marriage & Family Therapist (Licence: ND 2017-041A) | |
| 174400000X Specialist | |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2025-07-19 |