| NPI | 1801304472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 3604) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 3604) |
| 101YM0800X Counselor, Mental Health (Licence: OR 3604) | |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2024-11-25 |