| NPI | 1376736215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5234) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist (Licence: SC 1304) | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2022-07-21 |