NPI | 1619074358 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 17503) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 17503) |
103T00000X Psychologist (Licence: AZ 17503) | |
101YM0800X Counselor, Mental Health (Licence: AZ 17503) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: AZ 17503) | |
208000000X Pediatrics (Licence: AZ 17503) | |
Enumeration Date | 2006-09-17 |
Last Update Date | 2025-09-25 |