| NPI | 1821594193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 8244) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: PR 968) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2025-02-13 |