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 |