| NPI | 1558849174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 101709) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 101709) |
| 101YM0800X Counselor, Mental Health (Licence: NE 5324) | |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2020-10-30 |