| NPI | 1972752269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VT 048.0118565) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NY 019565) |
| 103TC0700X Psychologist Clinical (Licence: NY 019565) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NY 019565) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: VT 048.0118565) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: VT 048.0118565) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2016-08-23 |