NPI | 1326524380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12464) |
Additional Taxonomies | 103T00000X Psychologist (Licence: WY 724) |
103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
103TC2200X Psychologist, Clinical Child & Adolescent | |
Enumeration Date | 2018-07-12 |
Last Update Date | 2024-12-30 |