| NPI | 1891151635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 06657) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP6534) |
| 101YP2500X Counselor, Professional (Licence: MD LC8527) | |
| Enumeration Date | 2016-01-09 |
| Last Update Date | 2023-05-30 |