| NPI | 1124193156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: PA PS007878 L) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: PA 1133) |
| 103TC1900X Psychologist Counseling (Licence: PA PC000722) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |