| NPI | 1912215666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 129562) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO CSW00001400) |
| 1041C0700X Social Worker, Clinical (Licence: IA 129225) | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2024-12-04 |