| NPI | 1154429454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI PS01896) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 3728) |
| 103TC0700X Psychologist, Clinical (Licence: MA 7589) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 7589) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-08-20 |