| NPI | 1730210139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NM 0957) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NM 0957) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NM 0957) | |
| 103TC1900X Psychologist, Counseling (Licence: AR 91-16P) | |
| 103TF0000X Psychologist, Family (Licence: NM 0957) | |
| 103T00000X Psychologist (Licence: NM 0957) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2012-01-09 |