| NPI | 1649679077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 11659) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 7834-125) |
| 103T00000X Psychologist (Licence: NC 4650) | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2022-04-28 |