| NPI | 1649570078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4020) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2439) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2017-06-01 |