| NPI | 1821476573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 90507) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 101Y00000X Counselor (Licence: NC A15044) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2022-12-21 |