| NPI | 1053644047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSYC.00014089) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACB.0007055) | |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2019-09-09 |