NPI | 1477092047 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WY 708) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WY PPC-990) |
Enumeration Date | 2017-02-15 |
Last Update Date | 2024-01-17 |