| NPI | 1255750667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 4579) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PR 1065) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-21 |