| NPI | 1053925883 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MA 11376) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11376) | 
| 103TA0700X Psychologist, Adult Development & Aging | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2020-08-31 | 
| Last Update Date | 2021-12-29 |