| NPI | 1578807749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5726) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 5726) |
| Enumeration Date | 2012-11-12 |
| Last Update Date | 2016-04-21 |