| NPI | 1417281254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY.0005017) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 6857) |
| Enumeration Date | 2009-09-27 |
| Last Update Date | 2020-11-09 |