| NPI | 1689112997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810005838) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701005578) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2021-03-05 |