| NPI | 1508380932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 10128) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: RI ps01422) |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2017-07-27 |