| NPI | 1942291216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 0884) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: NM 00049) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2015-06-25 |