| NPI | 1255644712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2020-11-12 |