| NPI | 1003217845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 10979) |
| Additional Taxonomies | 101Y00000X Counselor |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2019-08-28 |