| NPI | 1700802196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 101YP2500X Counselor, Professional (Licence: OR C2006) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2007-07-08 |