| NPI | 1255512778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2009010491) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2009010491) |
| 101YP2500X Counselor, Professional (Licence: MO 2007035388) | |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2019-10-17 |