| NPI | 1255409538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 4317) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ME 1418) |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2018-10-03 |