| NPI | 1992114912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 10414) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2023-06-06 |