| NPI | 1679167506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-02-22 |