| NPI | 1164510368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 37792) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC001973) |
| 101YP2500X Counselor, Professional (Licence: NC 5402) | |
| 101YP2500X Counselor, Professional (Licence: NC 85402) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2018-12-12 |