| NPI | 1922305093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9026) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MA 1-07-3780) |
| 103T00000X Psychologist (Licence: MA 9026) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MA 9026) | |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2024-11-10 |