| NPI | 1053624262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 171M00000X Case Manager/Care Coordinator | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2023-06-20 |