| NPI | 1194037671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 8103) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PR 10399) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2024-12-12 |