| NPI | 1629465174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ID SE-203241) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-7507) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2021-04-30 |