NPI | 1306065867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 7322) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 7322) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 7322) | |
103TS0200X Psychologist, School (Licence: MA 7322) | |
Enumeration Date | 2007-04-24 |
Last Update Date | 2007-07-08 |