| NPI | 1023242229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 4180) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 8850) |
| 101YM0800X Counselor, Mental Health (Licence: NE 8850) | |
| 103TC1900X Psychologist, Counseling (Licence: AZ 4180) | |
| 103TF0000X Psychologist, Family (Licence: AZ 4180) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4180) | |
| 103TC0700X Psychologist, Clinical (Licence: AZ 4180) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: AZ 4180) | |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2011-06-27 |