| NPI | 1346537099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: RI PS01406) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI PS01406) |
| 103T00000X Psychologist | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2015-05-21 |