| NPI | 1730360983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO 4121) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 4820) |
| 101YM0800X Counselor, Mental Health (Licence: CO 4820) | |
| 101YP2500X Counselor, Professional (Licence: CO 4820) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2014-09-22 |