| NPI | 1538390513 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 37623) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist Clinical (Licence: CA 28185) | |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2018-03-17 |