| NPI | 1902233497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MA S09873554) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA S09873554) |
| 103T00000X Psychologist (Licence: MA S09873554) | |
| 104100000X Social Worker (Licence: MA S09873554) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2013-09-30 |