| NPI | 1750514949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9995) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9995) |
| 103TF0000X Psychologist, Family (Licence: MA 9995) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MA 9995) | |
| 103TH0004X Psychologist, Health (Licence: MA 9995) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2014-12-11 |