| NPI | 1063587962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MA 8206) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 8206) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2018-05-03 |