| NPI | 1760769806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9418) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: MA 9418) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: MA 9418) | |
| 103TC0700X Psychologist Clinical (Licence: MA 9418) | |
| 103TF0000X Psychologist Family (Licence: MA 9418) | |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |