| NPI | 1215260104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10102) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01295) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2015-03-30 |