| NPI | 1285283861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD LCPC11283) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LGP9421) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2022-02-04 |