| NPI | 1306925094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 106163) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 106163) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2009-12-08 |