| NPI | 1942459052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 094217) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2019-10-18 |