| NPI | 1154961548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 4094) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2021-08-30 |