| NPI | 1073887535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA PSY11942) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: OR 2175) |
| 103T00000X Psychologist (Licence: CA 25836) | |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2024-06-21 |