| NPI | 1124458492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 5312-57) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7470) |
| 106H00000X Marriage & Family Therapist (Licence: WI 377-228) | |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2025-04-11 |