| NPI | 1104903905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 2073) |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0002073) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-12-16 |