NPI | 1588814636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO PSY.0004952) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC.0014308) |
103TC1900X Psychologist Counseling (Licence: KS 1212) | |
Enumeration Date | 2008-09-25 |
Last Update Date | 2024-07-31 |