| NPI | 1053564955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9384) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9384) |
| 103T00000X Psychologist (Licence: RI 01233) | |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2020-12-02 |