| NPI | 1518386424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA PSY11899) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2024-05-13 |