| NPI | 1861700056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11133) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 023415-01) |
| 103TH0100X Psychologist, Health Service (Licence: MA 11133) | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2020-03-04 |