| NPI | 1699821918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7983) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103T00000X Psychologist (Licence: MA 7983) | |
| 103TS0200X Psychologist, School (Licence: MA 7983) | |
| Enumeration Date | 2007-01-27 |
| Last Update Date | 2007-07-08 |