| NPI | 1619343530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 4206) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist (Licence: PA PS018508) | |
| 103TC0700X Psychologist, Clinical (Licence: RI PS01670) | |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2023-05-03 |