| NPI | 1821190992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS 0768) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KS 220) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2011-10-03 |