| NPI | 1902259740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10040) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 14119) |
| Enumeration Date | 2016-07-17 |
| Last Update Date | 2019-05-06 |