| NPI | 1619270196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10856) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 13340) |
| 101YM0800X Counselor, Mental Health (Licence: MA 10113) | |
| 101YP2500X Counselor, Professional (Licence: MA 10113) | |
| 103TC1900X Psychologist, Counseling (Licence: MA 10856) | |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2019-07-16 |