| NPI | 1841541067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TP2701X Psychologist Group Psychotherapy |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2019-08-01 |