| NPI | 1578647590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 001131) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MO 2003030542) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-10-19 |