| NPI | 1760529457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: KS 1328) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS 0089) |
| 103G00000X Clinical Neuropsychologist (Licence: MO 00376) | |
| 103T00000X Psychologist (Licence: MO 00376) | |
| 103TH0004X Psychologist Health (Licence: MO 00376) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2015-08-20 |