| NPI | 1578632741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM 269) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NM 269) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NM 269) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2014-06-04 |