| NPI | 1982956215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 0012117) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 102L00000X Psychoanalyst | |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2022-06-21 |