| NPI | 1750708905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10729) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH11827) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-10-20 |