| NPI | 1215442504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 103TC1900X Psychologist, Counseling | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2017-12-07 |