| NPI | 1487612941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MO PYO 1451) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MO PYO 1451) |
| 103TF0000X Psychologist, Family (Licence: MO PYO 1451) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MO pyo1451) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MO PYO 1451) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2019-09-11 |