| NPI | 1609166131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 2963-57) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2013-12-10 |