| NPI | 1518536218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA PSY5000341) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: CT 0005) |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2026-04-07 |