| NPI | 1164527081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 6811) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 6811) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 6811) | |
| 103TF0000X Psychologist, Family (Licence: MA 6811) | |
| 103TH0100X Psychologist, Health Service (Licence: MA 6811) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MA 6811) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2010-06-22 |