| NPI | 1316297666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 3858) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PR 817) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |