| NPI | 1003291014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 10394) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 3269-57) |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2016-10-11 |