| NPI | 1003363987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 12004) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 5664) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2022-07-26 |