| NPI | 1215308689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005700) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005028) |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2019-09-09 |