NPI | 1104110162 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5024) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC 8708) |
Enumeration Date | 2011-06-07 |
Last Update Date | 2020-04-03 |