| NPI | 1003583568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000872) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2025-01-15 |