| NPI | 1194875294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 002963) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CT 002963) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CT 002963) | |
| 103TC1900X Psychologist, Counseling (Licence: CT 002963) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 002963) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: CT 002963) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2009-12-02 |