| NPI | 1831652866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 11017) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: MA 11017) |
| 103TA0700X Psychologist Adult Development & Aging (Licence: MA 11017) | |
| 103TC1900X Psychologist Counseling (Licence: MA 11017) | |
| 103TF0000X Psychologist Family (Licence: MA 11017) | |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-04-08 |