| NPI | 1649666926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 4116-57) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 2499 - 226) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2022-12-13 |