| NPI | 1285984310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 10288) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 1285984310) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2021-10-05 |