NPI | 1467983023 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11074) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VT 048.0134292) |
Enumeration Date | 2017-03-24 |
Last Update Date | 2023-12-08 |