| NPI | 1356644223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9911) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 8389) |
| 103T00000X Psychologist (Licence: MA 9911) | |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2019-04-09 |