| NPI | 1558644617 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 171100000X Acupuncturist (Licence: GA 87)  | 
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: GA 001798 LMSW)  | 
| 103TF0000X Psychologist, Family (Licence: GA 1798 LMSW)  | |
| Enumeration Date | 2011-09-26 | 
| Last Update Date | 2011-09-26 |