| NPI | 1457705626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 5323) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 24154) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2019-05-21 |