| NPI | 1265823181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MS 621148) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2022-11-07 |