NPI | 1023368644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY9109) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY9109) |
103TF0200X Psychologist, Forensic (Licence: FL PY9109) | |
Enumeration Date | 2012-09-11 |
Last Update Date | 2023-08-03 |