| NPI | 1366188237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TA0700X Psychologist Adult Development & Aging | |
| 103TC1900X Psychologist Counseling | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |