| NPI | 1508239773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3813-57) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 6402-125) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2020-07-21 |