| NPI | 1417943648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: PA PS006839L) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: PA PS006839L) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DE B1-0000464) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2007-07-08 |