| NPI | 1154730851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CO PSY.0004573) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000380) |
| 101YP2500X Counselor, Professional (Licence: CO LPC.0012040) | |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2022-04-14 |