| NPI | 1417254988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9632) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: MA 9632) |
| Enumeration Date | 2011-02-18 |
| Last Update Date | 2022-08-22 |