| NPI | 1477072593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: PR 5457) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: PR 5457) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: PR 5457) | |
| 103T00000X Psychologist (Licence: PR 5457) | |
| 101YM0800X Counselor Mental Health (Licence: PR 5457) | |
| 103TF0000X Psychologist Family (Licence: PR 5457) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: PR 5457) | |
| 106H00000X Marriage & Family Therapist (Licence: PR 5457) | |
| 106S00000X Behavior Technician (Licence: PR 5457) | |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |