| NPI | 1184853939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11771) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710101961) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0701003192) | |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2024-01-24 |