| NPI | 1083929442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 3867) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC 10433) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10433) | |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |