| NPI | 1164831632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11765) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS01916) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017869) | |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2022-04-14 |