| NPI | 1346296514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11495) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: RI PS00888) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2021-09-27 |