| NPI | 1902944549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701001122) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 02234) |
| 1041C0700X Social Worker Clinical (Licence: DC LC301008) | |
| Enumeration Date | 2007-02-04 |
| Last Update Date | 2007-07-08 |