| NPI | 1689638991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9242) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 4052) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2011-12-20 |