| NPI | 1265210348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT4716) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MT4716) |
| 103T00000X Psychologist (Licence: FL MT4716) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: FL MT4716) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL MT4716) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: FL MT4716) | |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-11-19 |