| NPI | 1912098260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 1980) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 1980) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-06-12 |