| NPI | 1336331248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 2798-057) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 3646-125) |
| 103TC0700X Psychologist Clinical (Licence: WI 2798) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2023-11-06 |