| NPI | 1447315049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 6495) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: MA 6495) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 6495) | |
| 103TC0700X Psychologist Clinical (Licence: MA 6495) | |
| 103TH0004X Psychologist Health (Licence: MA 6495) | |
| 103TH0100X Psychologist Health Service (Licence: MA 6495) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2016-04-01 |