| NPI | 1609181338 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: OR 052) | 
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: OR 050) | 
| Enumeration Date | 2010-08-18 | 
| Last Update Date | 2010-08-18 |