| NPI | 1609112747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 075061) |
| 103TC1900X Psychologist, Counseling (Licence: IA 075061) | |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2017-05-04 |