| NPI | 1023028123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 6720) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 6720) |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MA 6720) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 6720) | |
| 103TH0100X Psychologist Health Service (Licence: MA 6720) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2015-05-21 |