| NPI | 1861520330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM 1219) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0113351) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2019-06-28 |