| NPI | 1629011697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 2703) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WI 2703) |
| 101YP2500X Counselor, Professional (Licence: WI 3569) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2021-07-28 |