| NPI | 1386027449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 1503) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KS 2618) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 748) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2023-05-16 |