NPI | 1962668558 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: LA 1034) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TH0004X Psychologist, Health | |
Enumeration Date | 2008-08-03 |
Last Update Date | 2008-08-03 |