| NPI | 1710989215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: TN P-1271) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health (Licence: TN APRN-5128) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2011-06-29 |