| NPI | 1528302825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4471) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4471) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC 4471) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 4471) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NC 4471) | |
| 103TH0100X Psychologist, Health Service (Licence: NC 4471) | |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2013-07-31 |