| NPI | 1750398913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA LMHC 00092) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 00093) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-02-14 |