| 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 |