| NPI | 1902278146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 6723-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 2760-226) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: WI 2760-226) | |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2018-02-23 |