| NPI | 1457583643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 1135) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 257) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2012-05-16 |