| NPI | 1548331382 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 0656)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 1999142241)  | 
| 103T00000X Psychologist (Licence: KS 216)  | |
| Enumeration Date | 2006-11-13 | 
| Last Update Date | 2022-09-23 |