| NPI | 1932418084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: MA 339461) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 1028577) |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2012-12-06 |