| NPI | 1700958071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 4233) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service |
| 1041C0700X Social Worker Clinical | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2021-05-28 |