| NPI | 1487384103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA PSY10000286) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TC0700X Psychologist, Clinical (Licence: CO CO.00014727) | |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-10-05 |