NPI | 1124540497 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSB94023267) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 167373V) |
Enumeration Date | 2017-07-08 |
Last Update Date | 2018-06-16 |