| NPI | 1508604794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL LPC05398) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL ALC03512) |
| Enumeration Date | 2024-07-19 |
| Last Update Date | 2024-12-09 |