| NPI | 1861559957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 1054) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MT MT349) |
| 103TF0200X Psychologist, Forensic (Licence: MT MT349) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2007-07-08 |