| NPI | 1104910918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 7843) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MA 7843) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-01-05 |