| NPI | 1558480400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 6584) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: MA 6584) |
| 103TF0200X Psychologist, Forensic (Licence: MA 6584) | |
| 103T00000X Psychologist (Licence: MA 6584) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MA 6584) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-09 |