| NPI | 1699939058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701007496) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: WV 1020) |
| 101YP2500X Counselor Professional (Licence: WV 1895) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2021-03-18 |