| NPI | 1306999438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 2685 Psychology) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 102407 LICSW) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2007-07-08 |