| NPI | 1700958782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR coo17) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI PSY 876) |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY 7029) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |