| NPI | 1912308248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10583) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist (Licence: MA 1172) | |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2021-03-16 |