| NPI | 1326761248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: WV 1317) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: WV 1317) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2022-09-26 |