| NPI | 1811219470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 4357) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 63779) |
| Enumeration Date | 2010-02-24 |
| Last Update Date | 2019-03-05 |