| NPI | 1609407915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 4257) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY.0005174) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MA 319684) | |
| 103TH0004X Psychologist, Health (Licence: CT 4257) | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2022-11-03 |