| NPI | 1609276260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6830) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA LH60511087) |
| Enumeration Date | 2014-09-01 |
| Last Update Date | 2022-10-03 |