| NPI | 1659740819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ID PSY-203399) |
| 103TC0700X Psychologist Clinical (Licence: ID PSY-203399) | |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2021-11-02 |