| NPI | 1063904456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NE 1012) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 11496) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2020-07-31 |