| NPI | 1225655871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11238-PY-PR) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11238-PY-PR) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11238-PY-PR) | |
| 103TF0000X Psychologist, Family (Licence: MA 11238-PY-PR) | |
| 103TH0004X Psychologist, Health (Licence: MA 11238-PY-PR) | |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |