| NPI | 1710023023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IN 39000259A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY LPCC0072) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |