| NPI | 1578146460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 6451) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: PR 6451) |
| 101Y00000X Counselor (Licence: PR 1055) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 1055) | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |