| NPI | 1104069236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NY 18P68758) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NY 18P68758) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NY 18P68758) | |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-06-03 |