NPI | 1346467818 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8936) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 8936) |
103TF0000X Psychologist, Family (Licence: MA 8936) | |
Enumeration Date | 2007-04-19 |
Last Update Date | 2008-11-10 |