| 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 |