| NPI | 1437297603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 1126) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 1126) |
| 101YP2500X Counselor Professional (Licence: NC 1126) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-09-22 |