| NPI | 1417583782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12885) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: PR 1720) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2025-09-14 |