| NPI | 1922374438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 103509) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MD LC4260) |
| 101YM0800X Counselor Mental Health (Licence: NC 15139) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2023-01-06 |