| NPI | 1740424506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TP0814X Psychologist Psychoanalysis | |
| 103TR0400X Psychologist Rehabilitation | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2015-10-23 |