| NPI | 1851509004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 1590) |
| Additional Taxonomies | 103TP2701X Psychologist Group Psychotherapy (Licence: MA 1590) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2007-07-08 |