| NPI | 1215989801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9402) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 104955) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-03-07 |