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 |