| NPI | 1891819181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MA 10307) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10307) |
| 103TS0200X Psychologist, School (Licence: MA 10307) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2016-04-02 |