| NPI | 1366634677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 5480) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 5480-125) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2019-03-22 |