| NPI | 1407264047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3280-057) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 5392 - 125) |
| 103TC0700X Psychologist, Clinical (Licence: WI 3280-57) | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2020-05-06 |