| NPI | 1114495900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO 4843) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CO 4843) |
| 103TC1900X Psychologist, Counseling (Licence: CO 4843) | |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2019-04-03 |