| NPI | 1396874814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA PSB94028103) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: CA PSB94028103) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2026-09-08 |