| NPI | 1245435759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 5110) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN MN3087) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810003296) | |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2007-07-08 |