| NPI | 1861550220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 048-0000907) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 000083) |
| 101YM0800X Counselor Mental Health (Licence: VT 068-0000636) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-08-29 |