| NPI | 1255477584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9809) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KS 2001) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH9010) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-02-17 |