| NPI | 1861784068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ID 203518) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 18071) |
| 103T00000X Psychologist (Licence: WY 505) | |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2022-05-11 |