| NPI | 1992859037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 8123) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MA 4920) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2008-05-22 |