| NPI | 1578877007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 36934) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 48226) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2017-03-07 |