NPI | 1104108877 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 0005443) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-09-19 |
Last Update Date | 2023-04-21 |