| NPI | 1073723177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 4520) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 005424) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2019-05-08 |