| NPI | 1316282817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11259) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH16649) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2022-09-09 |