| NPI | 1336674712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO 2023020843) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical (Licence: MO 2023020843) | |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2024-11-03 |