| NPI | 1396131314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10770) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 10875) |
| 103TC0700X Psychologist, Clinical (Licence: MA 11123) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2021-04-27 |