| NPI | 1396055364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: PR 359) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TH0100X Psychologist Health Service | |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2010-10-08 |