| NPI | 1043969439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11835) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 6087) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2022-09-09 |