| NPI | 1164774469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9597) |
| Additional Taxonomies | 103TH0004X Psychologist, Health (Licence: MA 9597) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2020-09-25 |