| NPI | 1114076338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC003726) |
| 101YP2500X Counselor, Professional (Licence: PA PC003726) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-04-15 |