| NPI | 1508943366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 2695-057) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 650-125) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-04-08 |