| NPI | 1558136739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 887908) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IA 0094567) |
| 103T00000X Psychologist (Licence: IA 4546378) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: IA 5654786) | |
| 103TC1900X Psychologist Counseling (Licence: IA 857096) | |
| 103TF0000X Psychologist Family (Licence: IA 674569) | |
| 106H00000X Marriage & Family Therapist (Licence: IA 659900) | |
| 202D00000X (Licence: IA 070657) | |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2025-08-02 |