| NPI | 1255618963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 5054) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist (Licence: NC 5054) | |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2024-11-22 |