| NPI | 1083960520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 3721) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 9345) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2020-09-24 |