| NPI | 1235730151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: MA 450816) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 13103-MH-CC) |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2022-06-09 |