NPI | 1164638896 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10020) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2007-05-16 |
Last Update Date | 2019-06-06 |