| NPI | 1508032095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 9560) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 002770) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2024-01-09 |