| 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 |