NPI | 1316404338 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 11007) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11007) |
Enumeration Date | 2019-02-26 |
Last Update Date | 2019-07-12 |