| NPI | 1316580103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11192) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11192) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2023-05-09 |