| NPI | 1730477886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 4044) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 10002427) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2025-07-15 |