| NPI | 1255736153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: TN LDC0000001260) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2025-04-01 |