NPI | 1487228912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY11596) |
Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2021-05-19 |
Last Update Date | 2025-07-18 |