| NPI | 1700903549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: RI PS01501) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH 4495) |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2015-05-07 |