| NPI | 1962924779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 08100006469) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2020-04-06 |