| NPI | 1043590359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8464) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH4178) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2012-01-03 |