| NPI | 1770974644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 2657) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 2593) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2022-05-11 |