| NPI | 1548257447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MA 81165) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 81165) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2022-01-27 |