NPI | 1912256397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12243) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
101YM0800X Counselor, Mental Health (Licence: FL MH13383) | |
Enumeration Date | 2012-08-31 |
Last Update Date | 2024-04-24 |