| NPI | 1013353770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 377457) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 16884-130) |
| 106H00000X Marriage & Family Therapist (Licence: WI 348-228) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2020-04-15 |