| NPI | 1508070947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8513) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 426) |
| 103T00000X Psychologist (Licence: MA 8513) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MA 8513) | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-01-26 |