| NPI | 1760666895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4545) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC12790) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2015-02-10 |