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 |