| NPI | 1285899930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MS 641193) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MS 1824) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2025-07-14 |