| NPI | 1013229186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 3962) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 3962) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC 3962) | |
| 103TC0700X Psychologist, Clinical (Licence: NC 3962) | |
| 103TC1900X Psychologist, Counseling (Licence: NC 3962) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2020-04-15 |