| NPI | 1366487068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 7342) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 7342) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MA 7342) | |
| 103T00000X Psychologist (Licence: MA 7342) | |
| 106H00000X Marriage & Family Therapist (Licence: MA 7342) | |
| 103TE1100X Psychologist Exercise & Sports (Licence: MA 7342) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MA 7342) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: MA 7342) | |
| 103TH0100X Psychologist Health Service (Licence: MA 7342) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2007-07-09 |