NPI | 1699130195 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301016485) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301016485) |
103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MI 6361007845) | |
103TC0700X Psychologist, Clinical (Licence: MI 6361007845) | |
Enumeration Date | 2015-12-28 |
Last Update Date | 2024-10-16 |