| NPI | 1467588608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ME 506) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: ME PS506) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2016-05-18 |