| NPI | 1528375136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 9200) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 9200) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9200) | |
| 103TH0100X Psychologist, Health Service (Licence: MA 9200) | |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2010-09-02 |