| NPI | 1891034799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: MS 323163) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MS PH4975) |
| 103T00000X Psychologist (Licence: MS 323163) | |
| Enumeration Date | 2013-02-12 |
| Last Update Date | 2020-08-03 |