| NPI | 1629107156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 0470000386) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 000194-1) |
| 103TS0200X Psychologist School | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2009-11-14 |