| NPI | 1003540667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY3096) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH7792) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2022-08-24 |