| NPI | 1740425743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 8830) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MA 8830) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2020-08-27 |