| NPI | 1972795391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 8945) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: MA 8945) |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2009-10-14 |