| NPI | 1760473441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 3949-PY) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MA 3949-PY) |
| 103T00000X Psychologist (Licence: MA 3949-PY) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2012-11-21 |