| NPI | 1063784411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2014001357) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2011039220) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2016-02-05 |