NPI | 1194240549 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: HI psy2068) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: HI 1917-16) |
Enumeration Date | 2017-08-07 |
Last Update Date | 2023-03-15 |