| NPI | 1063866192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 003428) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: CT 003428) |
| 103T00000X Psychologist (Licence: CT 003428) | |
| 102X00000X Poetry Therapist (Licence: CT 003428) | |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-10-25 |