| NPI | 1053442202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: AZ 15698) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AZ LPC-0643) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2010-03-01 |