| NPI | 1689998098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103TF0000X Psychologist Family |
| 103TF0200X Psychologist Forensic | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2010-03-15 |