| NPI | 1366788606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8870) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY8870) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2013-09-23 |