| NPI | 1033279765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WV 1291) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WV 821) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-11-24 |