| NPI | 1609261049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY11758) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC0700X Psychologist Clinical (Licence: IN 20043121A) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-03-29 |