| NPI | 1659644383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 6694) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 1853) |
| 101Y00000X Counselor (Licence: NC 1853) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1853) | |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2024-12-07 |