| NPI | 1255665501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6347) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01307) |
| 103TH0004X Psychologist, Health (Licence: RI PS01307) | |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2019-04-01 |