| NPI | 1104962513 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OR 0718) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 0718) | 
| Enumeration Date | 2007-01-30 | 
| Last Update Date | 2023-03-02 |