| NPI | 1760650121 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9370)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| Enumeration Date | 2008-02-19 | 
| Last Update Date | 2016-12-29 |