| NPI | 1396213377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 156) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: KS LCAC99) |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-11-07 |