| NPI | 1811151376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ 42214) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ 42214) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2017-04-22 |