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 |