| NPI | 1255738860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 07336) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP5165) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC6504) | |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2025-01-08 |