| NPI | 1740735489 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 06284)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10705)  | 
| Enumeration Date | 2016-08-23 | 
| Last Update Date | 2022-05-25 |