| NPI | 1700671930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD A0993) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ADT3455) |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-04-09 |