| NPI | 1376584805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ME PS1240) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ME CC2537) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2010-10-27 |