| NPI | 1164501474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701003171) |
| 103TC0700X Psychologist, Clinical (Licence: PR 000291) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |