| NPI | 1003063090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 13162-132) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |