| NPI | 1508806290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005374) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH E.0007877) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-07-31 |