| NPI | 1366983694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 02938) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2017005257) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MO 2017037305) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2020-12-23 |