| NPI | 1922089531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MI 6301008884) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 6301008884) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2007-07-08 |