| NPI | 1053784918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MS 1995) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MS 1995) |
| 102L00000X Psychoanalyst (Licence: MS 1995) | |
| 103K00000X Behavior Analyst (Licence: MS 1995) | |
| Enumeration Date | 2015-11-01 |
| Last Update Date | 2022-07-06 |