| NPI | 1982614525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC3645) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 3645) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2011-08-02 |