| NPI | 1730236522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 6036) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103TF0200X Psychologist, Forensic | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2014-03-27 |