| NPI | 1326213745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 1583) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 31254) | |
| Enumeration Date | 2008-04-26 |
| Last Update Date | 2008-04-26 |