| NPI | 1033564885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 10986) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: 000) | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2019-01-17 |