| NPI | 1225134026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: AZ 4011) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: AZ 4011) |
| 103TC1900X Psychologist Counseling (Licence: AZ 4011) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: AZ 4011) | |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2014-08-07 |