| NPI | 1619010766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301012546) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |