| NPI | 1235814674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA PSY1000045) |
| Enumeration Date | 2023-06-21 |
| Last Update Date | 2024-04-10 |