| NPI | 1235276460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC68) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ID PSY372) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |