| NPI | 1376770719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 2460) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2015-02-09 |