NPI | 1275183394 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11649) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11649) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-09-19 |
Last Update Date | 2021-12-10 |