NPI | 1033753736 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10001472) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ PSY-005177) |
Enumeration Date | 2019-11-05 |
Last Update Date | 2025-06-11 |