NPI | 1689064016 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: DE 76486) |
101YM0800X Counselor, Mental Health (Licence: MX61148490) | |
Enumeration Date | 2015-01-23 |
Last Update Date | 2025-08-08 |