NPI | 1366739989 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10813) |
Additional Taxonomies | 101Y00000X Counselor |
103G00000X Clinical Neuropsychologist | |
Enumeration Date | 2011-07-03 |
Last Update Date | 2023-02-23 |