| NPI | 1023058419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 160200) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 160200) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-03-21 |