| NPI | 1457621781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 6278) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 7002) |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2017-04-21 |