| NPI | 1710176292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ID Psy-202119) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC 217) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |