| NPI | 1265818314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0004819) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 4819) | |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2021-12-02 |