| NPI | 1629185731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048.0063811) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 3658-125) |
| 101Y00000X Counselor (Licence: VT 068-0000212) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2011-01-12 |