| NPI | 1861530693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MA 4490) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MA 1917) |
| 106H00000X Marriage & Family Therapist (Licence: MA 996) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2011-09-24 |