| NPI | 1003207259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: HI PSY-1550) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI 2055-19) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI 2055-19I) | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2020-03-15 |