| NPI | 1578292579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12736) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 097.0135135) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2025-04-29 |