| NPI | 1902188246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: FL 072161070509) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 072161070509) |
| 106H00000X Marriage & Family Therapist (Licence: FL 072161070509) | |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |