| NPI | 1982680054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 2066) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 2066) |
| 103T00000X Psychologist (Licence: NC 2066) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NC 2066) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 2066) | |
| 103TC1900X Psychologist, Counseling (Licence: NC 2066) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2020-09-17 |