| NPI | 1053954297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VA 0810008895) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NY 009975) |
| 101YM0800X Counselor Mental Health (Licence: VA 0701008101) | |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2025-04-23 |