| NPI | 1669819363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 5188) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 1769226) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16672130) | |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2024-04-03 |