| NPI | 1548460637 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1070)  | 
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OR T-24-4310)  | 
| Enumeration Date | 2007-07-18 | 
| Last Update Date | 2025-08-12 |