| NPI | 1619919768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PS016629) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC003619) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2015-02-18 |