| NPI | 1952317844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AZ 3921) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ LISAC 10766) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-02-27 |