| NPI | 1598872442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 0253) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS LAC 1073) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2014-12-01 |