| NPI | 1780970780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY61677808) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY10002) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2026-02-17 |