| NPI | 1972972974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10205) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MA 10205) |
| 103TH0004X Psychologist, Health (Licence: MA 10205) | |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2017-05-09 |