| NPI | 1063729390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004377) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 12571) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2020-07-02 |