| NPI | 1851859102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003619) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CT 003619) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-06 |