| NPI | 1639574593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY7154) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH3825) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |