| NPI | 1215281183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: MA RN2351116) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ME XL3913) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2022-12-06 |