| NPI | 1750309282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00136) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2669) |
| 103T00000X Psychologist (Licence: IA 00136) | |
| 101YM0800X Counselor, Mental Health (Licence: WI 2669) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2025-09-11 |