| NPI | 1780782375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 269) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 291) | 
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2025-09-11 |