| NPI | 1114129327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0810003891) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: VA 0810003891) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2022-06-10 |