| NPI | 1124641451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11736) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC61059615) |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2022-12-12 |