| NPI | 1487913406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MA 9516) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: MA 9516) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2021-07-02 |