| NPI | 1609250570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MO 2019009041) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2015021358) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2022-06-15 |