| NPI | 1013508399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10000325) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: 523388) |
| Enumeration Date | 2021-01-29 |
| Last Update Date | 2025-09-29 |