| NPI | 1841624541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06102) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 10356) |
| 103TC0700X Psychologist, Clinical (Licence: NY 021447) | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2022-07-28 |