NPI | 1619526605 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 024269) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WA 61024141) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2019-09-11 |
Last Update Date | 2024-06-24 |