| NPI | 1497811574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 144) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NH 1035) |
| 103TC0700X Psychologist, Clinical (Licence: MA 8111) | |
| Enumeration Date | 2006-12-31 |
| Last Update Date | 2007-07-09 |