| NPI | 1952577629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WI 3002-57) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15310-132) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2023-01-26 |