| NPI | 1841714532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist Forensic (Licence: NY 022202-1) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 180.009753) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NY 022202-1) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: WI 3470-57) | |
| 103TC0700X Psychologist Clinical (Licence: NY 022202-1) | |
| 103TC0700X Psychologist Clinical (Licence: WI 3470-57) | |
| 103TF0200X Psychologist Forensic (Licence: WI 3470-57) | |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2022-07-21 |