| NPI | 1053637785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MA 9168) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: UT 6139302-2501) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2010-04-20 |