| NPI | 1790183176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1543) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AK 137972) |
| 101YP2500X Counselor, Professional (Licence: IL 178-000147) | |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2019-08-29 |