NPI | 1164672846 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8917) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 8917) |
Enumeration Date | 2008-09-30 |
Last Update Date | 2008-09-30 |