| NPI | 1669784757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MS 571007) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MS 571007) |
| 103TC0700X Psychologist, Clinical (Licence: MS 571007) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MS 571007) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2019-08-15 |