| NPI | 1174973572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SC 499) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: SC 499) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: SC 499) | |
| 103TC1900X Psychologist, Counseling (Licence: SC 499) | |
| 103TF0000X Psychologist, Family (Licence: SC 499) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |