| NPI | 1750448213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 4074) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MA 4074) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 4074) | |
| 103TC1900X Psychologist, Counseling (Licence: MA 4074) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 4074) | |
| 103T00000X Psychologist (Licence: MA 4074) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2012-11-13 |