| NPI | 1457343980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TP0814X Psychologist, Psychoanalysis (Licence: MA 7374) |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: MA 7374) |
| 103T00000X Psychologist (Licence: MA 7374) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 7374) | |
| 103TC0700X Psychologist, Clinical (Licence: MA 7374) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 7374) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2012-11-01 |