| NPI | 1669985172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AR 18-09P) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AR 18-09P) |
| 101YM0800X Counselor Mental Health (Licence: AR 18-09P) | |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2019-06-10 |