| NPI | 1710398995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: AZ 4494) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: AZ 4494) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AZ 4494) | |
| 103TC0700X Psychologist, Clinical (Licence: AZ 4494) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4494) | |
| 103TF0000X Psychologist, Family (Licence: AZ 4494) | |
| 103TF0200X Psychologist, Forensic (Licence: AZ 4494) | |
| 103TH0004X Psychologist, Health (Licence: AZ 4494) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: AZ 4494) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: AZ 4494) | |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-06-23 |