| NPI | 1649576612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6301018149) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 276214) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 1135) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-03369) | |
| 103TC0700X Psychologist, Clinical (Licence: OH P.08296) | |
| 103TC0700X Psychologist, Clinical (Licence: MI 6301018149) | |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2022-06-09 |