| NPI | 1659725950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: WI 5277-57) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 6590-125) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2024-10-04 |