| NPI | 1811228752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: AZ 4075) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AZ 4075) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: AZ 4075) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: AZ 4075) | |
| 103TC0700X Psychologist, Clinical (Licence: AZ 4075) | |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-09-02 |