| NPI | 1255784864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810006045) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10929) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2019-02-05 |