| NPI | 1679133367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 40747) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4159-226) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2025-09-17 |