| NPI | 1376981373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10339) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10339) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 10339) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MA 10339) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2016-04-26 |