| NPI | 1225149776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0812000241) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810002589) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |