| NPI | 1124334727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: PR 3630) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: PR 899) |
| Enumeration Date | 2010-08-20 |
| Last Update Date | 2010-08-20 |