| NPI | 1477059350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 11465) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist (Licence: MA 11465) | |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2021-09-02 |