| NPI | 1760690721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 9724) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MA 9724) |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MA 9724) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 9724) | |
| 103T00000X Psychologist (Licence: MA 9724) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2014-04-11 |