| NPI | 1750765517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 2666) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 1787) |
| Enumeration Date | 2015-07-11 |
| Last Update Date | 2015-07-11 |