| NPI | 1780804013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 2556) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PR 564) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2009-09-28 |