| NPI | 1114031903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7104) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 7104) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MA 7104) | |
| 103TH0100X Psychologist, Health Service (Licence: MA 7104) | |
| 103T00000X Psychologist (Licence: MA 7104) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2010-07-02 |