| NPI | 1396865242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19191) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 0589) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2022-11-21 |