| NPI | 1215072590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4538) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4538) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4538) | |
| 103TC1900X Psychologist, Counseling (Licence: AZ 4538) | |
| 103TS0200X Psychologist, School (Licence: AZ 4538) | |
| 101Y00000X Counselor (Licence: AZ LPC 0199) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2014-09-21 |