| NPI | 1851063531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ND 652) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 12586) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-10-30 |