| 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 |