| NPI | 1760769210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MO 2015037012) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2015011118) |
| Enumeration Date | 2011-11-11 |
| Last Update Date | 2020-12-22 |