| NPI | 1255469458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS017432) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA PC004163) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2013-09-20 |