| NPI | 1205101078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2870) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: NC 2870) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-2997) | |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2024-11-13 |