| NPI | 1255459723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 7445) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 1574) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2013-07-31 |