| NPI | 1003692419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 100000509) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 004531) |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2024-08-14 |