| NPI | 1609843531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PY 3501 PR) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: MA PY 3501 PR) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA PY 3501 PR) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-07-08 |