| NPI | 1770048928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PR 6197) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PR 4199) |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |