| NPI | 1669992541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3258) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 5227) |
| 101YM0800X Counselor, Mental Health (Licence: NE 11200) | |
| 101YM0800X Counselor, Mental Health (Licence: NE 601) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-04-26 |