| NPI | 1255990446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 4106) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: WI 4195-226) | |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2022-11-14 |