NPI | 1174199632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC CADC-24997) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NC CADC-24997) |
101YP2500X Counselor, Professional (Licence: NC CADC-24997) | |
Enumeration Date | 2021-06-03 |
Last Update Date | 2024-07-18 |