| NPI | 1396918256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI PS01246) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6209) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2011-09-14 |