| NPI | 1306996962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 4768) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MA 4768) |
| 103TF0000X Psychologist Family | |
| 103T00000X Psychologist (Licence: MA 4768) | |
| 106H00000X Marriage & Family Therapist (Licence: MA 181) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-08 |