| NPI | 1821198227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7157) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 7157) |
| 103TF0000X Psychologist, Family (Licence: MA 7157) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-08 |