| NPI | 1992254510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10413) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH13727) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2020-04-29 |