| NPI | 1700953270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NC 2668) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC 2668) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 2668) | |
| 103TF0000X Psychologist, Family (Licence: NC 2668) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2019-07-17 |