| NPI | 1245392463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2015042594) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2001022356) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2018-06-05 |