| NPI | 1871149229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: TN 14512) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC1900X Psychologist, Counseling (Licence: TN 14512) | |
| 103TC0700X Psychologist, Clinical (Licence: TN 14512) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: TN 14512) | |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2023-11-29 |