| NPI | 1750067963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KS 03165) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: KS 00765) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2023-06-22 |