| NPI | 1417902099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 4308) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 4308) |
| 103TC1900X Psychologist Counseling (Licence: MA 4308) | |
| 103TF0000X Psychologist Family (Licence: MA 4308) | |
| 103TH0100X Psychologist Health Service (Licence: MA 4308) | |
| 103T00000X Psychologist (Licence: MA 4308) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MA 4308) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2009-09-01 |