| NPI | 1356743728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY9127) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2020-09-17 |