| NPI | 1538243613 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3573-57) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 7027123) | 
| 106H00000X Marriage & Family Therapist (Licence: WI 679124) | |
| Enumeration Date | 2006-10-25 | 
| Last Update Date | 2021-11-22 |