| NPI | 1972565208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PY4954-PR) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 4954) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2016-03-18 |