| NPI | 1386972263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9944) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 7866) |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2014-09-02 |