| NPI | 1154711380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS018237) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist (Licence: PA PSO12801639) | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2023-05-03 |