| NPI | 1942216395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 103T00000X Psychologist | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-09 |