| NPI | 1316413081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11667) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 103TF0200X Psychologist, Forensic (Licence: MA 11667) | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2025-09-03 |