| NPI | 1720439698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ME PS2233) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810005871) |
| 101YM0800X Counselor, Mental Health (Licence: NE 10902) | |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2021-09-01 |