| NPI | 1679740963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4036-125) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 4036-125) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2022-08-15 |