| NPI | 1730231903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 1135) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA PSY001964) |
| 103T00000X Psychologist (Licence: AL 748) | |
| 103T00000X Psychologist (Licence: GA 1964) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |