| NPI | 1184605602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR 1473) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: OR 1473) |
| 103TC0700X Psychologist Clinical (Licence: OR 1473) | |
| 103TC1900X Psychologist Counseling (Licence: OR 1473) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 1473) | |
| 103TH0100X Psychologist Health Service (Licence: OR 1473) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: OR 1473) | |
| 103T00000X Psychologist (Licence: OR 1473) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2007-07-08 |