| NPI | 1538652433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10864) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 11520) |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2022-03-31 |