| NPI | 1972659142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME119963) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA G0747483) |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2018-11-09 |