| NPI | 1467946319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 7290-PY-PR) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MA 7290-PY-PR) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 7290-PY-PR) | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2018-06-14 |