| NPI | 1629276340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3780) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 6556) |
| 106H00000X Marriage & Family Therapist (Licence: NC 1353) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2012-08-27 |