| NPI | 1144597568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VT 048.0000904) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 048.0000904) |
| 101YM0800X Counselor, Mental Health (Licence: VT 048.0000904) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: VT 048.0000904) | |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2025-07-25 |