| NPI | 1902257512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service (Licence: OK 1327) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 10897) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2018-12-04 |