| NPI | 1275530487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 2953) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 2953) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 2953) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 2953) | |
| 103TF0000X Psychologist, Family (Licence: MA 2953) | |
| 103TH0100X Psychologist, Health Service (Licence: MA 2953) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2007-07-08 |