| NPI | 1467120659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 5000234) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810008232) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2023-09-12 |