| NPI | 1780994228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4151) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4151) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: AZ 4151) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: AZ 4151) | |
| 103TF0200X Psychologist, Forensic (Licence: AZ 4151) | |
| 103TH0004X Psychologist, Health (Licence: AZ 4151) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: AZ 4151) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2012-01-11 |