NPI | 1982139564 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MA 10950) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10950) |
103TP2701X Psychologist, Group Psychotherapy (Licence: MA 10950) | |
Enumeration Date | 2017-04-20 |
Last Update Date | 2019-12-19 |