| NPI | 1235275637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TN 3067) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 3724) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2012-10-08 |