| NPI | 1114209491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11535) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01812) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2022-07-20 |