| NPI | 1063479558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810003282) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: VA 0810003282) |
| 103T00000X Psychologist (Licence: VA 0810003282) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: VA 0810003282) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2011-02-16 |