| NPI | 1326459587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 116028) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: MA 116028) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |