| NPI | 1669466157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 001997) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: GA 001997) |
| 103T00000X Psychologist (Licence: GA 001997) | |
| 1041C0700X Social Worker, Clinical (Licence: GA 001997) | |
| 106H00000X Marriage & Family Therapist (Licence: GA 001997) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2007-07-08 |