| NPI | 1235400953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ME PS1336) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NH 1235) |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-01-26 |