| NPI | 1821635202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: CO 0011769) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0011769) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CO 260) | |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2019-12-05 |