| NPI | 1548524317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA 29646) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30156) |
| 103TC0700X Psychologist, Clinical (Licence: IL 071.008777) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2023-03-22 |