| NPI | 1972840874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PR 3840) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PR 1261) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-01-11 |