| NPI | 1154334738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4917) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 08100003648) |
| 103TC0700X Psychologist, Clinical (Licence: MD 04454) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |