| NPI | 1063070191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11522) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MA 11522) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 11522) | |
| 103TC0700X Psychologist, Clinical (Licence: MA 11522) | |
| 103TH0100X Psychologist, Health Service (Licence: MA 11522) | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2021-10-20 |