| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 103TF0200X Psychologist, Forensic |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 102L00000X Psychoanalyst |
| 103K00000X Behavior Analyst |
| 103TP2701X Psychologist, Group Psychotherapy |
| 1744R1102X Specialist, Research Study |
| 174H00000X Health Educator |
| 247200000X Technician, Other |
| 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-23 |