| NPI | 1629510649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0004481) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO PSY.0004481) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2018-01-15 |