| NPI | 1225222342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 27942) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2023-07-07 |