| NPI | 1548701360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000603) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA PSY10000603) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY12572) | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2025-03-12 |