| NPI | 1740528660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NH 1154) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NH 521) |
| 101YM0800X Counselor Mental Health (Licence: MA 4606) | |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-01-28 |