| NPI | 1700965126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7116) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MA 7116) |
| 103T00000X Psychologist (Licence: MA 7116) | |
| 103TH0100X Psychologist, Health Service (Licence: MA 7116) | |
| Enumeration Date | 2006-11-05 |
| Last Update Date | 2021-02-02 |