| NPI | 1811516651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry (Licence: MI 07048002) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| 171000000X Military Health Care Provider | |
| 1710I1002X Military Health Care Provider, Independent Duty Corpsman | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MI 07048002) | |
| 2085R0001X Radiology, Radiation Oncology (Licence: MI 07048002) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-12 |
| Last Update Date | 2022-03-31 |