| NPI | 1104424407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11369) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 3279) |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |