| NPI | 1992071112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PR 7246) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PR 1072) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2022-01-13 |