NPI | 1487107512 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0005030) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0012827) |
101YP2500X Counselor, Professional (Licence: CO 0012827) | |
Enumeration Date | 2016-07-25 |
Last Update Date | 2020-11-10 |