| NPI | 1497481949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 11936) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-10-18 |