| NPI | 1265806400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11794) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11794) | |
| Enumeration Date | 2015-11-27 |
| Last Update Date | 2022-05-11 |