| NPI | 1336257062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 8561) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC0700X Psychologist, Clinical (Licence: MA 8561) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MA 8561) | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |