| NPI | 1336715903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 4798) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 4798) |
| 103TC0700X Psychologist, Clinical (Licence: MA PSY11691) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA PSY11691) | |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2025-09-05 |