| NPI | 1922027036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: VT 048-0000758) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 048-0000758) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2008-09-26 |