| NPI | 1417401951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 11059) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10917) |
| 103T00000X Psychologist (Licence: RI 1745) | |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2019-06-12 |