| NPI | 1720186869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 768) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WV 1182) |
| 101YP2500X Counselor, Professional (Licence: TX 66102) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-09-29 |