| NPI | 1417013590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor School (Licence: MA 371455) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 6478) |
| Enumeration Date | 2006-12-31 |
| Last Update Date | 2007-07-08 |