| NPI | 1063061257 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA PSY11281)  | 
| Additional Taxonomies | 103T00000X Psychologist | 
| 103T00000X Psychologist (Licence: FL PSY10699)  | |
| Enumeration Date | 2019-09-10 | 
| Last Update Date | 2024-09-17 |