| NPI | 1598167512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 22) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2015-10-28 |