| NPI | 1215147673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: NV PY0742) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 002497) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-10-02 |