| NPI | 1750455937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810002996) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 07010001557) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2019-02-26 |