| NPI | 1124146717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 6917) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 6917) |
| 101YM0800X Counselor, Mental Health (Licence: MA 6917) | |
| 103T00000X Psychologist (Licence: MA 6917) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MA 6917) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 6917) | |
| 103TC0700X Psychologist, Clinical (Licence: MA 6917) | |
| 103TC1900X Psychologist, Counseling (Licence: MA 6917) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 6917) | |
| 103TF0000X Psychologist, Family (Licence: MA 6917) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2013-12-13 |