| NPI | 1376099770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY9608) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH12421) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2017-03-03 |