| NPI | 1063035566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MA 1597-PY-PR) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 1597) |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103T00000X Psychologist (Licence: MA 1597-PY-PR) | |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-05-19 |