| NPI | 1144473968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 3942) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 10439) |
| 101YP2500X Counselor, Professional (Licence: AZ 12449) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2008-10-23 |