| NPI | 1376548321 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 002013)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MO 01782)  | 
| Enumeration Date | 2005-06-16 | 
| Last Update Date | 2025-09-11 |