NPI | 1245435759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003296) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 5110) |
103T00000X Psychologist (Licence: MN MN3087) | |
Enumeration Date | 2007-06-15 |
Last Update Date | 2025-09-11 |