| NPI | 1427387117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 7102) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 101053) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2009-12-09 |