| NPI | 1518222868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810005362) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 13451) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2022-07-21 |