| NPI | 1992741953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA LICSW1023496) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 144039) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2009-10-19 |