| NPI | 1689883167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 124) |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) (Licence: PR 376) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-30 |