| NPI | 1568671238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS017651) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC003379) |
| 101YP2500X Counselor, Professional (Licence: TX 14971) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2014-09-06 |