| NPI | 1902055528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC LCAS-1932) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 3599) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2020-12-09 |