| NPI | 1093377558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 6491) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701008243) |
| 101YM0800X Counselor, Mental Health (Licence: IN 39003210A) | |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2023-12-13 |