| NPI | 1497738959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS LP0915) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA MFC21037) |
| 103T00000X Psychologist (Licence: MO PY01784) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2012-12-04 |