| NPI | 1023016920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: WV 841) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: WV 841) |
| 101YP2500X Counselor, Professional (Licence: WV 1232) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2010-12-02 |