| NPI | 1356828289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10953) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810006003) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-12-10 |