| NPI | 1962655910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071.008948) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2021-04-07 |