| 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 |