| NPI | 1326399890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005326) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical (Licence: MA 11658) | |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2021-12-05 |