| NPI | 1194897546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 047-0000631) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 4539) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2011-07-11 |