| NPI | 1942755020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 4043) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL MH21462) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2025-02-04 |