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 |