| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling |
| 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TF0000X Psychologist, Family |
| 103TP2701X Psychologist, Group Psychotherapy |
| 251B00000X Case Management |
| 251B00000X Case Management |
| Enumeration Date | 2021-11-21 |
| Last Update Date | 2023-08-15 |