| NPI | 1811297088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10097) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MA 000007496) |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2015-03-17 |