| NPI | 1437123577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 6494) |
| Additional Taxonomies | 103TS0200X Psychologist School (Licence: MA 282824) |
| 103T00000X Psychologist (Licence: MA 222) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2008-02-26 |