| NPI | 1174754055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 2141) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2009006660) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2017-03-29 |