| NPI | 1023556677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 11407) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PA PS018694) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2021-04-05 |