| NPI | 1013554435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY10363) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2020-04-28 |