NPI | 1649496977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH5875) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY6495) |
Enumeration Date | 2007-04-17 |
Last Update Date | 2007-07-08 |