| NPI | 1306930987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1360) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: NC 1360) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TC1900X Psychologist, Counseling | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |