| NPI | 1134278930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MA 4455) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 4455) |
| 103TF0000X Psychologist, Family (Licence: MA 4455) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |