| NPI | 1164805297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180.010866) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 102L00000X Psychoanalyst | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2020-01-29 |