| NPI | 1487783924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MA 7785) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7785) |
| 103TC0700X Psychologist Clinical (Licence: MA 7785) | |
| 103TF0000X Psychologist Family (Licence: MA 7785) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: MA 7785) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MA 7785) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2023-07-19 |