| NPI | 1558533976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: VA 0718000223) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC 1009) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MD LCA394) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2008-11-26 |