NPI | 1679092068 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: FL 11490) |
Additional Taxonomies | 101Y00000X Counselor |
103TC1900X Psychologist, Counseling (Licence: CT 3953) | |
Enumeration Date | 2017-09-17 |
Last Update Date | 2023-04-16 |