| NPI | 1548890262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: 0701008882) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: VA 0701008882) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |