| NPI | 1699012252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MD 03760) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MD 03760) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MD 03760) | |
| 103TF0000X Psychologist Family (Licence: MD 03760) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MD 03760) | |
| 103TR0400X Psychologist Rehabilitation (Licence: MD 03760) | |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-15 |