| NPI | 1245673102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11846) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2022-12-13 |