NPI | 1275884512 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05391) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2012-09-26 |
Last Update Date | 2019-01-29 |