| NPI | 1255538625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 8461) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 8461) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2020-02-29 |