| NPI | 1376524546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ME 1578) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7318) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2022-09-01 |