| NPI | 1194966101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 6295) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 410725) |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2015-05-01 |