| NPI | 1659473049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY11260) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH11168) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2021-10-13 |