| NPI | 1063716793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9441) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 9441) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2018-06-20 |