| NPI | 1962879072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810008685) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional (Licence: MT BBH-LCPC-LIC-37760) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2024-10-09 |