| NPI | 1114496031 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MA 10910)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MA 10910)  | 
| Enumeration Date | 2018-11-20 | 
| Last Update Date | 2018-11-20 |