| NPI | 1609170083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9847) |
| Additional Taxonomies | 261QV0200X Clinic/Center, VA (Licence: MA 9847) |
| 103T00000X Psychologist (Licence: MA 9847) | |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2023-07-05 |