| NPI | 1376713248 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: MS C6274) | 
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: ME LC677) | 
| 103TP2701X Psychologist, Group Psychotherapy (Licence: FL SW2983) | |
| Enumeration Date | 2008-03-07 | 
| Last Update Date | 2008-03-07 |