| NPI | 1871135749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 6664) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: 1363) |
| Enumeration Date | 2019-10-12 |
| Last Update Date | 2022-04-04 |