| NPI | 1609114172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61356985) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO PSY0005816) |
| 101YP2500X Counselor, Professional (Licence: CO LPC30012442) | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2023-11-14 |