| NPI | 1255301495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 02123) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD MD2123) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MD 4106) | |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810002291) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2021-01-21 |