| NPI | 1093583502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA PSY10000137) |
| Additional Taxonomies | 103TH0100X Psychologist Health Service (Licence: MA PSY1000137) |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2024-01-17 |