| NPI | 1275109316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA PSY10000012) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 38715) |
| Enumeration Date | 2021-05-30 |
| Last Update Date | 2023-08-09 |