| NPI | 1700819141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004096) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 0701003380) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2010-05-21 |