| NPI | 1902042344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 4186) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 103930) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2009-01-06 |