NPI | 1326248394 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003042) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC002287) |
Enumeration Date | 2007-07-18 |
Last Update Date | 2020-01-10 |