| NPI | 1255658779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10180) |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2016-11-16 |