| NPI | 1245688183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2019036263) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10214) |
| 101YM0800X Counselor, Mental Health (Licence: NE 542) | |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2021-09-16 |