| NPI | 1659759421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: OR 3450) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2023-04-25 |