| NPI | 1295099257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301015167) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MI 6301015167) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2024-04-23 |