| NPI | 1245886993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 11628) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11628) |
| 103T00000X Psychologist | |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2022-08-26 |