| NPI | 1538220751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 3003) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 3003) |
| 103TF0000X Psychologist Family (Licence: MA 3003) | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MA 3003) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: MA 3003) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MA 3003) | |
| 103TF0200X Psychologist Forensic (Licence: MA 3003) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2007-09-07 |