| NPI | 1063516052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701003050) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0701003050) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2019-08-27 |