| NPI | 1255421004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 047.0000698) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 151.0127410) |
| 103T00000X Psychologist (Licence: VT 047-0000698) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2024-01-22 |