| NPI | 1700134228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004905) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0810004905) |
| 103TC1900X Psychologist, Counseling (Licence: NC 4327) | |
| 103TC1900X Psychologist, Counseling (Licence: VA 0810004905) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: VA 0810004905) | |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2019-10-22 |