| NPI | 1255783056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MS 631171) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical (Licence: MS 631171) | |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2025-07-29 |