| 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 |