| NPI | 1578748372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS017676) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC004728) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2020-07-31 |