| NPI | 1346785102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810007727) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2022-03-15 |