| NPI | 1811631138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2022-04-22 |