| NPI | 1134450208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 32008) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 9940) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810002647) | |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2015-05-01 |