| NPI | 1558606806 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: NE 899) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 4585) | 
| Enumeration Date | 2012-11-27 | 
| Last Update Date | 2016-09-20 |