| NPI | 1740546241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 1968) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 22941) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |