| NPI | 1407042609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 19497) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA psy21181) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2007-09-20 |