| NPI | 1114344090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 3013) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |