| NPI | 1063791044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSY.0004233) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2016-07-20 |