| NPI | 1508425042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IA 095250) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| 103TP0814X Psychologist Psychoanalysis | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2019-06-09 |
| Last Update Date | 2019-06-09 |