| NPI | 1881762235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY1224) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA PSY1224) |
| 106H00000X Marriage & Family Therapist (Licence: MA PSY1224) | |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2007-07-08 |