NPI | 1043596893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0004897) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC-1240) |
Enumeration Date | 2011-10-25 |
Last Update Date | 2018-11-17 |