| NPI | 1912148784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: AZ 4469) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC-4811) |
| 103TC1900X Psychologist, Counseling (Licence: CO 4050) | |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2014-06-05 |