| NPI | 1699016345 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10951) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH11662) | 
| 106H00000X Marriage & Family Therapist (Licence: FL MT2763) | |
| Enumeration Date | 2013-03-05 | 
| Last Update Date | 2020-12-10 |