| NPI | 1891177143 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: OR 3278) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 103T00000X Psychologist (Licence: OR 3278) | |
| Enumeration Date | 2015-06-23 | 
| Last Update Date | 2023-07-18 |