| NPI | 1619558806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 8232-125) |
| 101YP2500X Counselor, Professional (Licence: WI 4203-226) | |
| 103TC0700X Psychologist, Clinical (Licence: WI 4019-57) | |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2024-07-23 |