| NPI | 1164013538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TE1100X Psychologist, Exercise & Sports | |
| 103TF0000X Psychologist, Family | |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |