| NPI | 1366581308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 7708) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7708) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MA 7708) | |
| 103TF0200X Psychologist Forensic (Licence: MA 7708) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2018-07-02 |