| NPI | 1427347533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10790) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 10790) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 10790) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2020-09-01 |