| NPI | 1659386084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CO 2890) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 2890) |
| 103TC1900X Psychologist, Counseling (Licence: CO 2890) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |