| NPI | 1508174400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM 1335) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2014-10-16 |