| NPI | 1275173536 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 39274) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: 18390) | 
| Enumeration Date | 2020-01-14 | 
| Last Update Date | 2022-09-09 |