| NPI | 1710102116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC002793) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS003132L) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-07-08 |