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