| NPI | 1346754744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11115) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 5782) |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2022-06-02 |