NPI | 1770149254 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000258) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103T00000X Psychologist (Licence: MA PSY10000258) | |
Enumeration Date | 2019-05-10 |
Last Update Date | 2024-10-02 |