| NPI | 1821507344 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 2958) | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: OR 2958) | 
| Enumeration Date | 2017-09-27 | 
| Last Update Date | 2019-12-27 |